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Cervical Cancer

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What's the Problem?

Cervical cancer is largely preventable, yet according to the American Cancer Society, an estimated 13,000 new cases of invasive cervical cancer will be diagnosed in 2002 and about 4,100 women will die of the disease. The cervix is located at the bottom of the uterus and forms a canal leading to the vagina. Cellular changes sometimes occur on the surface of the cervix. Cervical cancer rates are higher among older women; however, cervical intraepithelial neoplasia (or CIN), the precursor lesion to cervical cancer, most often occurs among young women. Minority populations and persons of low socioeconomic status are affected disproportionately as well.

Who's at Risk?

Studies that have identified risk factors associated with cervical cancer have shown that cervical cancer is closely linked to failure to receive regular Pap test screening, the presence of the human papillomavirus (HPV) infection, intercourse at an early age, multiple male sexual partners, and sex with a male partner who has had multiple sexual partners and immunosuppressive disorders such as HIV/AIDS.

Experts agree that infection with certain strains of the HPV is one of the strongest risk factors for cervical cancer. Experts also agree that one of the most important things women can do to reduce their risk of cervical cancer is to receive regular screening with a Pap test.

Can It Be Prevented?

The most effective way to prevent cervical cancer is through regular Papinacolaou screening, every three years after three consecutive normal tests. Sixty percent of all diagnosed cervical cancers are in women who are never or rarely screened (i.e., have not received a Pap test in 5 years or more). Abnormal cellular changes to the cervix can be detected by the Pap test and treated before cancer can develop.

The Bottom Line

Abnormal cells are sometimes found on the surface of the cervix;

getting a regular Pap test allows for detection of cellular changes before cancer develops; and

the most important steps to preventing cervical cancer are receiving regular pelvic exams and Pap tests.

Case Example

Rachel, 49, is a busy woman with three children in school, a career, and a husband. If she is not rushing from the office to take the children to a soccer game, piano lessons, or to a friend's house, she is planning how her family will survive without her during a sudden two-day business trip she has to take. Over the last few months she has been experiencing pain and bleeding during and after sex with her husband. But she has been too busy to make a doctor's appointment and believes that this may be related to early menopause. She is past the childbearing years and does not think she is at risk for cervical cancer. Rachel does finally decide to go see her OB-GYN when the pain continues. She realizes she has not had a Pap test in more than 6 years. Her doctor did a pelvic exam and Pap test. A few days later, Rachel got a call from her doctor - the Pap test came back positive for abnormal cells. Rachel went back to the doctor for more testing. The tests revealed cervical cancer. She was lucky that the cancer had not spread and was treatable.